Understanding dental stains is very important for maintaining beautiful smile. Besides the color and shape of teeth, stains on teeth are biggest embarrasing factors in otherwise beautiful smile. There are many reasons for dental stains. Some of these are within our control and some some are natural or genetic. These are discussed as under:
1. Intrinsic stains
2. Extrinsic stains
These are due to the agents or medicaments like flurides, tetracycline etc. These are basically caused from the "inside" and are harder than extrinsic. The treatment options for them is bonding or veneering.
These are due to tea, coffee and tobacco etc. as discussed earlier. These are caused from ‘outside’. Treatment option for them is tooth bleaching or whitening. One should know that in this the surface of the tooth is not removed but it lightens the color of your tooth. Teeth change the color as the person gets old.
Chemicals causing Extrinsic Stains: metallic stains, chlorhexidine.
Routinely acquired stains: certain beverages and foods, poor oral hygiene, gingival bleeding, tobacco stains, plaque, etc. The tooth alone gets discolored after root canal treatment (RCT). So in this case the root canal is opened again and the bleaching agent or solution is applied inside the tooth. To restore your smile the simplest method is to get your teeth bleached. To have a wide dazzling smile people get their teeth bleached. This gives them confidence by setting good impression on other people.
There are many ways you can have or you can restore the healthy smile of yours. The most effective one is bleaching and other than that you can go for composites, porcelain veneering, implants, etc.
1. In office bleaching method.
2. OTC (Over the Counter) or home bleaching method.
3. Whitening toothpastes.
In office bleaching can also be called as Laser or Power Bleaching (Jump Start Procedure). Whereas the home bleaching is considered as stand alone procedure.
Over the Counter (OTC) are not considered that effective as the trays used in this are not custom made, so they donot fit that well. Thus the agent used inside the tray may irritate the gingiva (gums). One main thing to be mentioned is that the OTC products are not recommended by American Dental Association.
Tetracycline Stains: Superoxol and a thermostatically controlled heat source is used for bleaching. It acts only superficially and not on the dentin. But the method causes pulpal reaction. But many studies were carried out some said that the heat application resulted in inflammation and some said it has no effect on the pulp. Superoxol causes pulpal inflammation, hemorrhage, and also odontoblasts layer destruction. But these reactions were reversible and healing occurs in 60 days. For this the best treatment is patient should go for labial composite veneering and porcelain jacket crown.
Post-eruptive causes of Intrinsic Stains: Trauma, dental caries, aging, pulpal changes, restorative materials, functional and other Para functional changes.
Endemic Fluorosis : Solution of ether, HCl, superoxol is used for bleaching. As discussed later, the ether is 0.2 ml and it removes the deposits on the tooth surface, HCl is 0.1 ml and it results in the etching of enamel surface, superoxol is 1.0 ml which causes enamel bleaching.
Pre-eruption causes of Intrinsic Stains: Hematological diseases, enamel and dentine defect, liver diseases, alkaptonurea, medications like – tetracycline stains, fluorosis etc.
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